# PROVIDENCE HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROVIDENCE HOSPITAL
- **Other names:** Anesthesia Group
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1992133912
- **Legal business name:** PROVIDENCE HOSPITAL
- **Authorized official:** MR. TODD S. KENNEDY (PRESIDENT)
- **Authorized official phone:** (251) 633-1660

## Contact information

- **Practice address:** 6801 AIRPORT BLVD, ANESTHESIA DEPT., MOBILE, AL 36608-3709
- **Practice address phone:** (251) 631-3272
- **Practice address fax:** (251) 631-3273
- **Mailing address:** 3687 WHEELER RD, AUGUSTA, GA 30909-6521
- **Mailing address phone:** (800) 394-4445
- **Mailing address fax:** (706) 396-3252

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/30/2013
- **Last updated:** 09/29/2015